Sleep and suicide: A systematic review and meta-analysis of longitudinal studies

Probably not a substantial claim: may not pass S3 (load-bearing).

Sleep disruption has been conceptualized as a manifestation of the over-arousal characteristic of acute suicide risk.

“sleep disruption has been conceptualized as a manifestation of the over-arousal characteristic of this period of acute suicide risk (Ribeiro et al., 2015; Rogers et al., 2016; Tucker et al., 2016).”

• cites Ribeiro et al., 2015 sourceSupported
• cites Rogers et al., 2016 sourceNot checked — no full text of the source
• cites Tucker et al., 2016 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Several current theoretical perspectives hold that acute suicide risk occurs during relatively short-lived periods of heightened arousal or agitation.

“several current theoretical perspectives hold that acute suicide risk occurs during relatively short-lived periods of heightened arousal or agitation (Deisenhammer et al., 2009; Miller & Prinstein, 2019; Tucker et al., 2016; Wolfe-Clark & Bryan, 2017)”

• cites Deisenhammer et al., 2009 sourceNot checked — no full text of the source
• cites Miller & Prinstein, 2019 sourceSupported
• cites Tucker et al., 2016 sourceNot checked — no full text of the source

May combine two claims.

A more recent meta-analysis focusing exclusively on psychiatric patient samples categorized 11 studies as employing a longitudinal design, and just six of these featured longitudinal analyses.

“A more recent meta-analysis, focusing exclusively on psychiatric patient samples (Malik et al., 2014) categorized 11 studies as employing a longitudinal design, and just six of these featured longitudinal analyses.”

• cites Malik et al., 2014 sourcePartly supported

  The Results section (‘Description and quality of included studies’; page unavailable) reports that 11 of 19 studies were prospective, supporting the count of longitudinal designs. The paper concerns psychiatric patients, but the passages do not establish that only six of those studies performed longitudinal analyses; searches for that distinction found no supporting passage. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

I2 values of approximately 25%, 50%, and 75% indicate low, moderate, and substantial heterogeneity, respectively.

“Low heterogeneity is indicated by I2 values of approximately 25%, and moderate heterogeneity by I2 values of 50%. Substantial heterogeneity attributed to real differences in study samples and methodology is indicated by an I2 value of 75%”

• cites Higgins et al., 2003 sourcePartly supported

  In “How much is too much heterogeneity?” (page not indicated), the paper tentatively labels I² values of 25%, 50%, and 75% as low, moderate, and high. It cautions that these labels are not appropriate in every circumstance; a value of 75% alone does not establish that differences in study samples and methodology caused the heterogeneity. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Psychosocial stress impairs sleep.

“Although it has been proposed that this theory may apply to suicide (Bernert & Joiner, 2007) and psychosocial stress does indeed impair sleep (Kim & Dimsdale, 2007), this possibility remains untested.”

• cites Kim & Dimsdale, 2007 sourceSupported

May combine two claims.

Chronic or relatively stable processes and characteristics are likely more relevant to long-term or general risk, and their low temporal variance makes them less able to predict short-term risk robustly.

“This is an important consideration because chronic or relatively stable processes and characteristics are likely more relevant to understanding long-term or general risk (Glenn et al., 2017), and their relatively low temporal variance means they lack the temporal sensitivity required to be robust predictors of short-term risk.”

• cites Glenn et al., 2017 sourceSupported

May combine two claims.

A few studies found evidence that the sleep-STB association is unidirectional: sleep predicts later suicidal thoughts and behaviors, at least suicidal ideation, but suicidal ideation does not predict later sleep behavior.

“It is therefore noteworthy that in addition to demonstrating temporal precedence in the relation between sleep disturbance and STBs, a few studies have found evidence that this association is unidirectional; not only does sleep temporally predict STBs, at least in the case of suicidal ideation, but suicidal ideation, in turn, does not predict subsequent sleep behavior (Littlewood et al., 2019;”

• cites Littlewood et al., 2019 sourceSupported
• cites Ribeiro et al., 2012 sourceNot checked — no full text of the source

May combine two claims.

State-sensitive phenomena are more promising for short-term risk and likely poor indicators of long-term risk.

“Contrastingly, state-sensitive phenomena are more promising candidates for short-term risk (Glenn & Nock, 2014) and likely poor indicators of long-term risk.”

• cites Glenn & Nock, 2014 sourceSupported

May combine two claims.

Sleep disturbance, including insomnia, prospectively predicted suicidal thoughts and behaviors, with effect sizes ranging from small-to-medium to medium.

“Sleep disturbance, including insomnia, prospectively predicted STBs, yielding small-to-medium to medium effect sizes for these associations.”

May combine two claims.

Few studies of suicidal ideation and suicide attempts, and none of suicide deaths, assessed short-term risk using follow-up assessments of under a month.

“few studies of suicidal ideation and suicide attempts, as well as none of suicide deaths, assessed short-term risk (i.e., employed follow-up assessments of under a month).”

May combine two claims.

Only two studies examined sleep disturbance in relation to suicide attempts over a follow-up of one month or less, and none examined this for suicide deaths.

“As only two studies evaluated sleep disturbance in relation to suicide attempts over a follow-up period of one month or briefer, and none in the case of sleep disturbance predicting suicide deaths”

May combine two claims.

Studies of overall sleep disturbance predicting later suicidal ideation over less than a year had significantly larger effects than studies with follow-ups of a year or more, and follow-up length remained a significant moderator in meta-regression.

“Supportive of an influence of length of follow-up on weighted effect sizes, studies of overall sleep disturbance prospectively predicting suicidal ideation over a period of under a year yielded significantly larger effects than did those with follow-ups of a year or more, and the moderator effect of follow-up length remained significant in a meta-regression analysis.”

May combine two claims.

For insomnia and later suicide attempts, Egger's test indicated significant publication bias, and trim-and-fill correction produced a larger pooled effect, adjusted d = .44, 95% CI .15 to .73.

“In both cases, Egger’s regression test indicated the existence of significant publication bias. Trim-and-fill analyses and corresponding funnel plots (Figures 2d and 2e), however, indicated whereas correcting for publication bias would yield a smaller pooled effect for suicidal ideation (adjusted d = .37, 95% CI = .25 – .49), it would produce a larger pooled effect in the case of suicide attempts”

May combine two claims.

In the case of sleep disturbance in relation to later suicide attempts, only suicide measure type emerged as a significant moderator, with a larger pooled effect observed for questionnaire measures (d = .53, 95% CI .27-.79) than for interview-based ones (d = .12, 95% CI −.08-.32).

“In the case of sleep disturbance in relation to later suicide attempts, only suicide measure type emerged as a significant moderator, with a larger pooled effect observed for questionnaire measures (d = .53, 95% CI = .27 – .79) than for interview-based ones (d = .12, 95% CI = −.08 – .32).”

May combine two claims.

For insomnia, median follow-up increased from 10.5 months for suicidal ideation to two years for suicide attempts to 8.7 years for suicide deaths.

“A nearly identical pattern was observed for insomnia, with median follow-ups increasing from 10.5 months for suicidal ideation to two years for suicide attempts to 8.7 years for suicide deaths.”

May combine two claims.

For hypersomnia and suicidal ideation, the pooled effect was trivial and non-significant, d = .09, 95% CI −.07 to .25.

“Overall, evidence for an association between hypersomnia and STBs appeared modest, with non-significant pooled effects that were trivial for suicidal ideation (d = .09, 95% CI = −.07 – .25) and small-to-medium for suicide attempts (d = .31, 95% CI = −.56 – 1.17).”

May combine two claims.

In univariate moderator analyses, sleep measure type and length of study follow-up assessment moderated the association between sleep disturbance and prospective suicidal ideation.

“In univariate moderator analyses, sleep measure type and length of study follow-up assessment moderated the association between sleep disturbance and prospective suicidal ideation.”

May combine two claims.

For overall sleep disturbance and later suicide deaths, trim-and-fill and the funnel plot indicated that the literature may underestimate the association, with adjusted d = .58, 95% CI .31 to .86.

“As for sleep disturbance in relation to prospective suicide deaths, Egger’s regression test yielded no evidence of publication bias whereas both the trim-and-fill analysis and the corresponding funnel plot (Figure 2c) suggested that the existing literature may underestimate the strength of this association (adjusted d = .58, 95% CI = .31 – .86).”

May combine two claims.

When follow-up lengths of a month or briefer versus over a month were considered, both length of follow-up assessment (b = .26, p < .01) and sleep measure type (b = .26, p = .02) remained significant moderators, with this multivariate model accounting for 67% of the variance in effect sizes for the association between sleep disturbance and suicidal ideation.

“When follow-up lengths of a month or briefer versus over a month were considered, both length of follow-assessment (b = .26, p < .01) and sleep measure type (b = .26, p = .02) remained significant moderators, with this multivariate model account for 67% of the variance in effect sizes for the association between sleep disturbance and suicidal ideation.”

May combine two claims.

For insomnia predicting suicide deaths, the pooled effect was small-to-medium, d = .30, 95% CI .20 to .41, with follow-ups from one to 36 years and a median of 8.7 years.

“As for insomnia as a predictor of suicide deaths, a small-to-medium pooled effect was found (d = .30, 95% CI = .20 – .41), with follow-ups ranging from one to 36 years (median follow-up length = 8.7 years).”

May combine two claims. The quote only partly states this claim.

For hypersomnia and suicide attempts, the pooled effect was small-to-medium and non-significant, d = .31, 95% CI −.56 to 1.17.

“Overall, evidence for an association between hypersomnia and STBs appeared modest, with non-significant pooled effects that were trivial for suicidal ideation (d = .09, 95% CI = −.07 – .25) and small-to-medium for suicide attempts (d = .31, 95% CI = −.56 – 1.17).”

May combine two claims.

For insomnia and later suicidal ideation, Egger's test indicated significant publication bias, and trim-and-fill correction produced a smaller pooled effect, adjusted d = .37, 95% CI .25 to .49.

“In both cases, Egger’s regression test indicated the existence of significant publication bias. Trim-and-fill analyses and corresponding funnel plots (Figures 2d and 2e), however, indicated whereas correcting for publication bias would yield a smaller pooled effect for suicidal ideation (adjusted d = .37, 95% CI = .25 – .49), it would produce a larger pooled effect in the case of suicide attempts”

May combine two claims.

Significant heterogeneity was present for suicidal ideation, suicide attempt, and suicide death, and thus moderator analyses were indicated.

“Significant heterogeneity was present for suicidal ideation, suicide attempt, and suicide death, and thus moderator analyses were indicated.”

Probably not a substantial claim: may not pass S3 (load-bearing).

None of the studies with suicide deaths had follow-ups shorter than a year.

“Incidentally, none of the studies with suicide deaths included follow-ups briefer than a year.”

May combine two claims.

When follow-ups of one month or less were compared with longer follow-ups, the pooled effect was medium-to-large for up to one month and small-to-medium for longer follow-ups.

“This finding held when follow-ups of a month or briefer were compared to longer follow-ups, with a medium-to-large pooled effect observed for follow-ups of up to one month compared to a small-to-medium pooled effect in the case of longer follow-ups.”

May combine two claims.

For suicide deaths, moderator analyses could not be conducted for age as a categorical variable, time-frame covered by the sleep measure, suicide measure type, time-frame covered by the suicide measure, and length of follow-up assessment.

“In the case of suicide deaths, it was not possible to conduct moderator analyses for age as a categorical variable (i.e., all but one sample was with adults), time-frame covered by the sleep measure (i.e., all studies either had time-frames of less than a month or provided no information on this design feature), suicide measure type (i.e., all studies used death records), time-frame covered by the”

May combine two claims.

Only four included studies of overall sleep disturbance and suicide attempts had follow-ups under a year, compared with 13 studies for suicidal ideation.

“Although follow-up length did not also significantly moderate the strength of the association between overall sleep disturbance and suicide attempts, only four of the included studies featured follow-ups of under a year, in contrast to 13 in the case of suicidal ideation.”

May combine two claims.

For overall sleep disturbance, median follow-up increased with outcome severity: 10.5 months for suicidal ideation, two years for suicide attempts, and 10 years for suicide deaths.

“For overall sleep disturbance, median follow-ups were quite substantial, increasing in duration with increasing severity of STB, from 10.5 months for suicidal ideation to two years for suicide attempts to 10 years for suicide deaths.”

May combine two claims.

A notable proportion of included studies did not report sample race data, and even fewer reported ethnicity, though reporting appears to have improved in recent years.

“First, a notable proportion of studies did not report data on the race of their samples, and even fewer on ethnicity, although there appears to be improvement in reporting practices in more recent years.”

May combine two claims.

Six studies of overall sleep disturbance and suicidal ideation had follow-ups of one month or less, while only two studies with suicide attempts had comparable follow-up intervals.

“Six studies of overall sleep disturbance and suicidal ideation included follow-ups of one month or briefer, whereas only two studies with suicide attempts as the outcome featured follow-up intervals of comparable length.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The final set comprised 41 articles included in the review.

“This resulted in a final set of 41 articles included in the current review”

May combine two claims.

A total of 26 unique effects were obtained for the association between sleep disturbance and prospective suicidal ideation, 13 for future suicide attempts, and 14 for associations with suicide deaths.

“A total of 26 unique effects were obtained for the association between sleep disturbance and prospective suicidal ideation, 13 for future suicide attempts, and 14 for associations with suicide deaths”

May combine two claims.

The study with the shortest follow-up for suicide attempts, three days, had the largest effect among studies with that outcome, d = .85.

“Of note, the study with the briefest follow-up period for suicide attempts (i.e., three days; Ribeiro, Huang, Fox, Walsh, & Linthicum, 2019) yielded the largest effect (d = .85) among studies”

• cites Ribeiro, Huang, Fox, Walsh, & Linthicum, 2019 sourceNot checked — no full text of the source

May combine two claims.

Significantly less empirical research has focused on the relationship between sleep indices and suicide outcomes using longitudinal designs, leaving unclear the strength of sleep disturbance as a true risk factor for suicidal thoughts and behaviors.

“Significantly less empirical research has focused on the relationship between sleep indices and suicide outcomes utilizing longitudinal designs, leaving unclear the strength of sleep disturbance as a true risk factor for STBs.”

Classified as probably not a substantial claim. May combine two claims.

Correlates are determined with cross-sectional designs, lack evidence of temporal precedence, cannot establish prospective prediction, and cannot be ruled out as concomitants or epiphenomena of the mental health outcome.

“In contrast to risk factors, correlates are determined with cross-sectional designs and therefore lack evidence of temporal precedence; correlates cannot establish prospective prediction and cannot be ruled out as concomitants or epiphenomena of the mental health outcome of interest.”

May combine two claims.

The pooled effects for sleep disturbance and suicidal thoughts and behaviors are generally similar in size to those in meta-analyses of psychological and psychopharmacology treatments for mental health conditions, often over shorter periods.

“As additional context for interpreting these pooled effects, it may be noted that they are generally comparable in size to those found in meta-analyses of psychological and psychopharmacology therapies for a variety of mental health conditions, often over much briefer periods of time (e.g., Cuijpers et al., 2010, 2014; Weisz et al., 2017).”

• cites Cuijpers et al., 2010, 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Weisz et al., 2017 sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

Studies with small effect sizes or non-significant findings are less likely to be published, may be more likely to be excluded from meta-analyses, and can result in a potentially inflated estimate of the overall effect size.

“As studies with small effect sizes or non-significant findings are less likely to be published, these studies may be more likely to be excluded from meta-analyses, resulting in a potentially inflated estimate of the overall effect size.”

May combine two claims.

Except for a preliminary non-significant association between hypersomnia and later suicidal ideation, results across overall sleep disturbance, insomnia, hypersomnia, and nightmares consistently showed positive associations with all later suicidal thoughts and behaviors.

“With the exception of a preliminary finding of a non-significant relation between hypersomnia and subsequent suicidal ideation, the results of analyses across several manifestations of sleep disturbance (i.e., overall disturbance, insomnia, hypersomnia, and nightmares) were consistent in yielding positive associations with all subsequent STBs (i.e., suicidal ideation, suicide attempts, and suicide”

Probably not a substantial claim: may not pass S3 (load-bearing).

Standard guidelines classify Cohen's d of .20 as small, .50 as medium, and .80 as large.

“Standard guidelines for Cohen’s d were used to determine the size of the effect (i.e., .20 = small effect size, .50 = medium, and .80 = large; Kraemer et al., 2003).”

• cites Kraemer et al., 2003 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S4 (based).

Sleep disturbance may confer risk for suicidal thoughts and behaviors through neuroinflammatory and stress processes and associated impairments in executive control.

“providing a model of how sleep disturbance may confer risk for STBs through neuroinflammatory and stress processes and associated impairments in executive control.”

Probably not a substantial claim: may not pass S3 (load-bearing).

These reporting findings are generally consistent with a recent systematic review of sample-characteristic reporting in the suicide literature.

“These findings are generally consistent with those in a recent systematic review of reporting practices of sample characteristics in the suicide literature (Cha et al., 2018).”

• cites Cha et al., 2018 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Significant heterogeneity suggests the need to conduct moderator analyses to identify potential sources.

“Significant heterogeneity suggests the need to conduct moderator analyses to identify potential sources of this heterogeneity.”

Classified as probably not a substantial claim. May combine two claims.

Duval and Tweedie's trim-and-fill analysis and Egger's regression intercept were used to account for potential publication bias.

“To account for the presence of potential publication bias, Duval and Tweedie’s trim-and-fill analysis (Duval & Tweedie, 2000) and Egger’s regression intercept (Egger et al., 1997) were used.”

• cites Duval & Tweedie, 2000 sourceNot checked — no full text of the source
• cites Egger et al., 1997 sourceNot checked — no full text of the source

• AssumptionThe authors state this as an assumption: Duval and Tweedie’s trim-and-fill procedure assumes homogeneity of effect sizes.

May combine two claims.

The body of literature has expanded considerably since the earlier meta-analysis, such that there are now sufficient longitudinal studies to observe the distinction between each form of suicidal thought and behavior in separate meta-analyses.

“The body of literature has expanded considerably since then such that the small number of available longitudinal studies at the time necessitated collapsing across STBs in evaluating the association between sleep disturbance and suicide, whereas there are now a sufficient number of longitudinal studies to observe the important distinction between each form of STB in separate meta-analyses.”

May combine two claims.

The two remaining meta-analyses focused exclusively on sleep behavior in adolescents, with one featuring only two studies with longitudinal analyses included in the current review, and the other none.

“The two remaining meta-analyses focused exclusively on sleep behavior in adolescents, with one featuring only two studies with longitudinal analyses included in the current review (Liu, Tu, et al., 2019), and the other none (Chiu et al., 2018).”

• cites Liu, Tu, et al., 2019Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Chiu et al., 2018 sourceNot checked — no full text of the source

May combine two claims.

Only one systematic review has focused specifically on longitudinal associations between sleep and suicide, a narrative review of adolescent studies.

“there has been only one systematic review focusing specifically on longitudinal associations between sleep and suicide, a narrative review of adolescent studies.”

• cites Kearns et al., 2020 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

A possible reason for the smaller interview effects is that most interview measures were not designed to assess sleep and instead used items from diagnostic depression interview modules.

“It is possible that this finding emerged given that the majority of the interview measures used were not specifically designed to measure sleep, and instead used items pulled from diagnostic interview depression modules (e.g., Hamilton Depression Rating Scale, the Schedule for Affective Disorders and Schizophrenia).”

May combine two claims.

For overall sleep disturbance and insomnia, pooled effect sizes fell in the small-to-medium to medium range, ds = .30 to .50, and changed little after publication-bias adjustment.

“For overall sleep disturbance and insomnia, both having a sizeable number of unique effects for quantitative analyses, the pooled effect sizes were all within the small-to-medium to medium range (ds = .30 to .50), which remained largely unchanged after adjusting for potential publication bias.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Each search result was independently reviewed for eligibility by two authors, with discrepancies resolved by a third author.

“Each search result was independently reviewed for eligibility by two authors. In the event of a discrepancy between authors, it was resolved independently by a third author.”

May combine two claims.

Sleep disturbance and insomnia have enough predictive power to yield pooled effect sizes of ds ≥ .39 and .30, respectively, over long follow-up periods, which indicates their value for understanding suicide risk.

“That sleep disturbance and insomnia have sufficient predictive power to produce pooled effect sizes of ds ≥ .39 and .30, respectively, for these outcomes over such lengthy stretches of time speaks to their value in understanding suicide risk.”

Classified as probably not a substantial claim.

One prior meta-analysis found that cross-sectional designs may produce larger effect sizes (RR = 3.14) than longitudinal designs (RR = 1.94) in the relation between sleep disturbance and suicide risk.

“one of these prior meta-analyses has found that cross-sectional designs may produce larger effect sizes (RR = 3.14) than longitudinal designs (RR = 1.94) in this relation (Pigeon et al., 2012).”

• cites Pigeon et al., 2012 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

The majority of studies in that narrative review provided evidence of a prospective relation between sleep problems and suicidal thoughts and behaviors.

“The majority of the studies in this review provided evidence of a prospective relation between sleep problems and suicidal thoughts and behaviors (Kearns et al., 2020).”

• cites Kearns et al., 2020 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable).

Publication bias is an important consideration when conducting meta-analyses.

“Publication bias is an important consideration when conducting meta-analyses.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A conceptual model is outlined in which sleep disturbance participates in stress processes to confer suicide risk through neuroinflammation-induced impairments in executive control.

“Finally, as a potential framework for future work in this area, a conceptual model is outlined, wherein sleep disturbance is involved in stress processes to confer suicide risk through neuroinflammation-induced impairments in executive control.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Life stress, especially interpersonal stressors, may play a prominent role in risk for suicidal thoughts and behaviors, particularly short-term risk.

“There is accumulating evidence that life stress, particularly interpersonal stressors, may play a prominent role in risk for STB (Liu & Miller, 2014), especially short-term risk (Bagge et al., 2013).”

• cites Liu & Miller, 2014 sourceNot checked — no full text of the source
• cites Bagge et al., 2013 sourceNot checked — no full text of the source

May combine two claims.

Most studies to date have evaluated sleep disturbance as a long-term risk factor for suicidal thoughts and behaviors, leaving unclear how well disrupted sleep predicts short-term risk.

“The vast majority of studies to date, however, have evaluated sleep disturbance as a long-term risk factor for STBs, leaving unclear the degree to which disrupted sleep predicts short-term risk, a question of considerable clinical relevance, given that clinical risk assessments are more focused on determining whether an individual will engage in suicidal behavior in the near future.”

• AssumptionRests on an assumption: Clinical risk assessments focus on determining whether an individual will engage in suicidal behavior in the near future.

Probably not a substantial claim: may not pass S3 (load-bearing).

Social zeitgeber theory holds that psychosocial stress may increase depression risk by disrupting social routines and thereby biological circadian rhythms.

“Interestingly, theoretical support for interpersonal stress leading to sleep dysregulation relevant to suicide risk may be found in the social zeitgeber theory (Ehlers et al., 1988). This theory holds that psychosocial stress may increase risk for depression by disrupting an individual’s social routines, and thereby their biological circadian rhythms.”

• cites Ehlers et al., 1988 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Suicide risk has been found to be elevated or increasing in several traditionally underrepresented racial and ethnic populations.

“Thorough reporting of sample sociodemographic characteristics is important for evaluating the generalizability of findings to traditionally underrepresented racial and ethnic groups, especially as risk for suicide has been found to be elevated or increasing in several of these populations (Sheftall et al., 2016).”

• cites Sheftall et al., 2016 sourceNot checked — no full text of the source